Characteristics and Prognosis of Patients with Hepatocellular Carcinoma at Campus Teaching Hospital of Lome
- 1 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
- 2 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
- 3 Gastroenterology Unit of Teaching Hospital of Kara, Kara, Togo
- 4 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
- 5 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
- 6 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
- 7 Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome, Lome, Togo
Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, as well as in Togo, where it is a major public health problem. HCC is the third most common cause of death from cancer. Chronic infection with HBV and HCV is the most important cause of HCC. Objective: To determine the epidemiological, diagnostic and evolutionary aspects of HCC in the hepatology and gastroenterology department of Campus Teaching Hospital of Lomé. Patients and method: Descriptive and analytical study, conducted from January 1, 2013 to December 31, 2017, on all patients admitted in the hepatology and gastroenterology department of Campus Teaching Hospital of Lome for hepatocellular carcinoma. The statistical analysis was done using Stata 13 software. The significance threshold was used for p < 0.05. Findings: A total of 250 patients were retained. Hospital prevalence was 6.1%. There was a male predominance with a sex ratio of 2.84. The average age was 47.15 ± 13.85 (extreme: 20 - 85 years). The average duration of symptoms was 67.08 ± 82.59 days. Pain in the right hypochondrium was the most common reason for consultation (64.6%). The average AFP value was 24,062 ± 33,318 ng/ml. Ultrasound found more than two nodules in 74.75% of cases and a portal thrombosis in 64.97% of cases. The main etiologies found were chronic hepatitis B (55%) and C (8%) virus infections. The majority (89.20%) of patients were in the BCLC D stage. Survival at 6 months was 45%. Factors associated with death were: chronic ethylism (OR = 16.87, p = 0.002), jaundice (OR = 341.57, p = 0.004), rupture of esophageal varices (OR = 42.45, p = 0.008) and a BCLC D score (OR = 9.82, p = 0.041). Conclusion: Young adults were the most affected by HCC, whose etiologies are dominated in our context by hepatitis B and C viruses. The majority of our patients consulted late and was found at the terminal stage of the disease, limiting any therapeutic possibility. In this situation, the best attitude remains prevention.
- Parkin, D.M., Brany, F., Ferlay, J. and Pisani, P. (2005) Global Cancer Statistics 2002. CA: A Cancer Journal for Clinicians, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
- Kew, M.C. (2013) Epidemiology of Hepatocellular Carcinoma in Sub-Saharan Africa. Annals of Hepatology, 12, 173-102. https://doi.org/10.1016/S1665-2681(19)31354-7
- Kew, M.C. (2009) Challenges of Managing Hepatocellular Carcinoma in Sub Saharan Africa. Nigerian Journal of Gastroenterology and Hepatology, 1, 7-13.
- Jacobsen, K.H. and Wiersma, S.T. (2010) Hepatitis A Virus Seroprevalence by Age and World Region, 1990 and 2005. Vaccine, 28, 6653-6657. https://doi.org/10.1016/j.vaccine.2010.08.037
- Jemal, A., Bray, F., Center, M.M., et al. (2011) Global Cancer Statistics. Carcinogenesis, 61, 69-90.
- Yang, J.D. and Roberts, L.R. (2010) Epidemiology and Management of Hepatocellular Carcinoma. Infectious Disease Clinics of North America, 24, 899-919. https://doi.org/10.1016/j.idc.2010.07.004
- Lohoues-Kouacou, M.J., Toure, M., Hillah, J., Camara, B.M., N’Dri, N., et al. (1998) Transmission materno-fætale du virus de l’hépatite B en Cote d’Ivoire. Cahiers Santé, 8, 401-404.
- N’gbesso, R.D., Attia, A., Mahassadi, A., Kanga, N., Yoman, T.N., Kéita, A.K. and Manlan, K.L. (1998) Cancers hépatocullaires (CHC) observes à Abidjan: Aspects et place de l’échographie. Journal de Radiologie, 79, 409-414.
- Bruix, J. and Sherman, M. (2011) American Association for the Study of Liver D. Management of Hepatocellular Carcinoma: An Update. Hepatology, 53, 1020-1022. https://doi.org/10.1002/hep.24199
- European Association for the Study of The L, European Organization for R, Treatment of C (2012) EASL-EORTC Clinical Practice Guidelines: Management of Hepatocellular Carcinoma. Journal of Hepatology, 56, 908-943. https://doi.org/10.1016/j.jhep.2011.12.001
- Stigliano, R., Marelli, L., Yu, D., Davies, N., Patch, D. and Burroughs, A.K. (2007) Seeding Following Percutaneous Diagnostic and Therapeutic Approaches for Hepatocellular Carcinoma. What Is the Risk and the Outcome? Seeding Risk for Percutaneous Approach of HCC. Cancer Treatment Reviews, 33, 437-447. https://doi.org/10.1016/j.ctrv.2007.04.001
- Kissi Anzouan-Kacou, H.Y., Kouamé, D.H., Fanou, D.C., Doffou, S.A. and Ndri-Yoman, T.A. (2017) Aspects clinique et diagnostic du carcinome hepatocellulaire en Cote d’Ivoire. Revue Internationale des Sciences Médicales d’Abidjan, 19, 179-184.